Basic Information
| Provider Information | |||||||||
| NPI: | 1417047762 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EHRMANN | ||||||||
| FirstName: | PAUL | ||||||||
| MiddleName: | ROBERT | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2033 CROOKS RD | ||||||||
| Address2: | |||||||||
| City: | ROYAL OAK | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480734049 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2485432000 | ||||||||
| FaxNumber: | 2485432043 | ||||||||
| Practice Location | |||||||||
| Address1: | 2033 CROOKS RD | ||||||||
| Address2: | |||||||||
| City: | ROYAL OAK | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480734049 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2485432000 | ||||||||
| FaxNumber: | 2485432043 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/14/2006 | ||||||||
| LastUpdateDate: | 11/25/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 5101007918 | MI | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 382719497 | 01 | MI | TAX ID# | OTHER |